Belly Birth Parents, I “C” You
Cesarean Birth Part 1: Pregnancy, Birth, and early Postpartum
Did you know
That Cesarean section, also called C-Section, Cesarean delivery, or belly birth, is the most common inpatient surgery in Canada. Statistics for North America estimate that about 1/3 of all births are belly births, (one third of babies born in Canada are born by C-section!) and that number is increasing.
Despite increasing numbers of belly births, there is surprisingly little literature (research) or patient guidelines available, especially when compared to other common inpatient surgeries such as knee or hip replacements. Unfortunately the available research does not often focus on the preferences of birthing parents, or provide clinicians with guidance for effective post-surgical treatment or rehabilitation.
What does this mean for you?
My hope here is to put good, evidence-based information in your hands (where possible), so you can understand where information is coming from, ask the right questions, and prepare your home for the early postpartum days.
Content Warning: this blog contains images of birthing persons, operation rooms, and Cesarean section surgery. If you would like this information in an alternative format please contact us.
Before we start, a guide to this blog…
What is evidence-based care?
Evidence-based medicine, evidence-based care, evidence-based practice - all are of similar meaning and refer to a style of care that relies on three “pillars”:
Best available evidence: even if evidence is lacking for C-section rehab, there are dedicated researchers upping the standard of care.
Note: If you want to read a recent research paper (or send it to your care team) hit the hyperlink to learn more about what can be offered.Practitioner experience or expertise: gained through treating similar conditions in clinic, and learning from other experienced clinicians
Patient preference
Let’s take a moment for that third piece of the puzzle. What matters to you? Do you have pain? Are you having feeding difficulties? Do you want to return to running or sporting activities? Is getting up from the floor difficult for you? Do you feel like it’s too late for rehab? (Spoiler alert: it’s never too late!)
As evidence-based practitioners we use your goals and concerns to make your treatment plan, guided by relevant bodies of evidence and experiences we’ve had treating similar conditions in the past.
What is Cesarean birth?
Here is an awesome video that demonstrates the steps involved in belly birth. Before you click away - the surgery is demonstrated with playdough, balloons, and a Spiderman doll - so don’t worry if you’re a bit blood squeamish.
Just because cesarean delivery is common, does not mean it is “easy”. C-sections are a major abdominal surgery - so keep this in mind as you are gentle with yourself and your recovery.
Who should prepare for a C-section?
Every person who will birth a baby, and their birth support person(s) (partner, doula, friend, parent, family member) should “prepare” for a belly birth by knowing what questions to ask, and how to help you advocate for yourself to your health and/or birth team. Even if you’re planning for a different type of birth, this can help you be prepared in the event your birth plan changes.
What can I do to prepare for a C-section?
One of the best ways to prepare for a belly birth is by creating a list of questions to ask your birth care team. If you need help making that list, talk to professionals such as prenatal educators, pelvic floor physiotherapists, and chiropractors who have additional training in postnatal recovery. They may guide you to ask questions about risks and benefits, wound care, skin-to-skin, feeding baby, or other questions you may not have thought of yet.
For some folks and families, hiring a doula or birth worker might be the right choice:
A birth doula (or other birth worker): help you advocate for yourself and support you (and/or your partner) during birth
A postpartum doula (or postpartum birth worker): pre-scheduling postpartum visits may alleviate stress and provide needed help while you recover from your birth
How do you prepare for a C-section?
While every hospital and care team has different recommendations for what to bring, and what your stay will involve, here are a couple things to consider.
Before surgery:
Pack some chewing gum for the hospital: chewing gum after a C-section may help improve gut motility after birth. Ask your care team if this is right for you.
Ask your care team to prepare you for transitions in and out of bed, on-and-off toilet, and preparing to cough or sneeze. It’s easier to learn before your recovery.
After surgery:
Ensure you know how to transition as above. If you need a refresher, or if anything new is giving you trouble, ask your care team to give you a refresher. Navigating transitions can become more intimidating during night feeds, or when hospital staff is no longer near you, so empower yourself before you go home.
Towels, padding, or pillows to brace yourself when coughing or sneezing. Providing a little extra support over your incision will alleviate some pain and stress.
When driving home be mindful of the seatbelt against your incision as bumps on the road can be very aggravating! Ask your care team if they recommend anything specific for this.
How to prepare your home for C-section recovery
Prepare your home so your living space is prepared and ready to go the moment you walk in the door. Ideally your space will have all of your essentials on the same floor, with no stairs between you and whatever it is you need. In your space, include a comfortable place to recline (bonus points for electric recliners that change positions with the touch of a button). Reclining may be the most comfortable position for you to sleep, and may be helpful when feeding baby. Keep a cart with a "stash” of supplies on hand. There are many configurations to consider, but include the essentials:
Diaper change items such as extra diapers, creams, and wipes, and clothes
Items for feeding baby such as nursing pads, extra towels or receiving blankets, pump attachments or supplies
Self-care items such as a nail file, snacks (lots of snacks), bottles of water or other beverages, phone chargers
Entertainment for older children: activities or games, snacks, etc.
Underrated (bonus!) item: a stand, attachment, or tripod for an iPad or tablet. This is especially useful for virtual visits with family or if you seek out early postpartum healthcare visits such as virtual lactation consulting or virtual postpartum rehab visits with your chiropractor or physiotherapist.
Your space is set, but what about the rest of the home?
Meal plan and prep: stock your freezer with easy meals you can pop in the oven from frozen. Some of our favourite “oven” meals include lasagna, shepherd’s pie, casseroles, and protein fillings for tacos/fajitas/quesadillas. You may want to avoid foods that make you gassy, and make available foods that help keep you regular.
Once again an honourable mention for postpartum doulas: some doulas offer basic home cleaning, laundry services, overnight visits, or baby minding while parents sleep. These services can be booked in advance and can be a stress saver.
Disclaimer: we acknowledge that this is not possible in all homes, living situations, and financial backgrounds. These are suggestions and not requirements.
What can I do to assist my recovery after a C-section?
“You’ll need help. And rest. There’s nothing else. Take rest more seriously than you’ve ever taken it in your life”
-anonymous
The best thing you can do is seek reputable advice from a pelvic floor physiotherapist or chiropractor with additional training in postnatal recovery. If you don’t have a chiro or physio yet, a prenatal educator, lactation consultant, doula, or midwife can recommend someone to you.
Everyone’s recovery is different. After surgery, individualized advice is best. Some folks are ready to reconnect with their pelvic floors and core muscles quickly after birth, while others require more time for a variety of reasons. An experienced musculoskeletal specialist will be able to help you navigate your recovery.
One thing we recommend: virtual care. Why?
You receive access to care more quickly (as soon as you’re ready!)
You don’t have to worry about childcare, lifting car seats, driving, or finding someone to drive you to the clinic
Whether you are chestfeeding, breastfeeding, or bottle feeding, if you are having postural pain or strain we can observe your home setup and provide advice
We can observe or discuss your current rehab plan and progress from the comfort of your own home
Regardless of virtual or in-office formats, early postpartum recovery after C-section may include a combination of advice, very basic activation “exercise,” very basic “stretch,” or “mobility” work, breathwork, advice on transfers (sitting up, rolling over, etc.), referrals to other practitioners, and whatever else suits your goals.
Before you go: we’d like the final part in our Cesarean Birth series to be stories, tips, advice and “I wish I’d known that…” from folks like you, all anonymized of course. If there’s something you think is missing from our pregnancy and early postpartum post, we’d love to hear from you. Please reach out by phone or email to share your thoughts!
Looking for advice? Book a complimentary 15-minute meet and greet with Dr. B, our pregnancy and postpartum expert.